MOD-DOC INC
NPI 1801627096
Nurse Practitioner - Primary Care in Kaysville, UT

Active since August 09, 2024CLIA 46D2329583 · Waiver
1188 W SPORTSPLEX DR STE 102, KAYSVILLE, UT 84037(801) 449-9229(385) 325-6055 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 27, 2026, Dec 17, 2025, Aug 9, 2024 (3 updates tracked since 2024).

About Mod-doc Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOD-DOC INC (NPI 1801627096) is a healthcare organization registered as a primary care in Kaysville, Utah and active in the NPI registry since August 2024. The organization holds a CLIA Waiver certificate valid through September 1, 2027 and lists Jeff Midgley, Owner / President, as its authorized official.

NPPES Registry Identity

NPI1801627096
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameMOD-DOC INC
Location Address1188 W SPORTSPLEX DR STE 102Kaysville, UT 84037-6816
Mailing Address1188 W Sportsplex Dr Ste 102Kaysville, UT 84037-6816 · (801) 449-9229 · Fax (385) 325-6055
Fax(385) 325-6055
Organization SubpartNo
Authorized OfficialJeff MidgleyOwner / President · (801) 449-9229
Enumeration DateAugust 9, 2024
Last NPPES UpdateApril 27, 20263 updates tracked since enumeration
NPPES CertifiedApril 27, 2026
NPI 1801627096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
1188 W SPORTSPLEX DR STE 102, Kaysville, UT 84037

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2329583

Mod Doc Kaysville LLC · Kaysville, UT
Active · expires Sep 1, 2027
CLIA Number46D2329583
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 2, 2025
Certificate Expiration DateSeptember 1, 2027
Laboratory DirectorDonald R. Hastie
Laboratory Phone(801) 654-2042
Laboratory LocationMod Doc Kaysville LLC1188 W Sportsplex Dr, Suite 102, Kaysville, UT 84037
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
1188 W SPORTSPLEX DR STE 102
KAYSVILLE, UT 84037

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mod-Doc Inc's NPI number?

The NPI number for Mod-Doc Inc is 1801627096. It was assigned to this organization in the NPPES registry on August 9, 2024.

Where is Mod-Doc Inc located?

Mod-Doc Inc is located at 1188 W Sportsplex Dr Ste 102, Kaysville, UT 84037. The listed phone number is (801) 449-9229.

What is Mod-Doc Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Does Mod-Doc Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2329583) is associated with this NPI, valid through September 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mod-Doc Inc accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Mod-Doc Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mod-Doc Inc was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.